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Diagnostics
Volume 11
Issue 6
10.3390/diagnostics11061035
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Article

Seeing Beyond Morphology-Standardized Stress MRI to Assess Human Knee Joint Instability

by
Eva-Maria Winkelmeyer
1,
Justus Schock
2,
Lena Marie Wollschläger
2,
Philipp Schad
1,
Marc Sebastian Huppertz
1,
Niklas Kotowski
1,
Andreas Prescher
3,
Christiane Kuhl
1,
Daniel Truhn
1 and
Sven Nebelung
1,2,*
1
Department of Diagnostic and Interventional Radiology, Aachen University Hospital, 52074 Aachen, Germany
2
Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, D-40225 Duesseldorf, Germany
3
Institute of Anatomy, RWTH Aachen University, 52074 Aachen, Germany
*
Author to whom correspondence should be addressed.
Diagnostics 2021, 11(6), 1035; https://doi.org/10.3390/diagnostics11061035
Submission received: 27 April 2021 / Revised: 25 May 2021 / Accepted: 1 June 2021 / Published: 4 June 2021
(This article belongs to the Section Medical Imaging and Theranostics)
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Abstract

While providing the reference imaging modality for joint pathologies, MRI is focused on morphology and static configurations, thereby not fully exploiting the modality’s diagnostic capabilities. This study aimed to assess the diagnostic value of stress MRI combining imaging and loading in differentiating partial versus complete anterior cruciate ligament (ACL)-injury. Ten human cadaveric knee joint specimens were subjected to serial imaging using a 3.0T MRI scanner and a custom-made pressure-controlled loading device. Emulating the anterior-drawer test, joints were imaged before and after arthroscopic partial and complete ACL transection in the unloaded and loaded configurations using morphologic sequences. Following manual segmentations and registration of anatomic landmarks, two 3D vectors were computed between anatomic landmarks and registered coordinates. Loading-induced changes were quantified as vector lengths, angles, and projections on the x-, y-, and z-axis, related to the intact unloaded configuration, and referenced to manual measurements. Vector lengths and projections significantly increased with loading and increasing ACL injury and indicated multidimensional changes. Manual measurements confirmed gradually increasing anterior tibial translation. Beyond imaging of ligament structure and functionality, stress MRI techniques can quantify joint stability to differentiate partial and complete ACL injury and, possibly, compare surgical procedures and monitor treatment outcomes.
Keywords: knee joint; anterior cruciate ligament; magnetic resonance imaging; physiology; biomechanical phenomena knee joint; anterior cruciate ligament; magnetic resonance imaging; physiology; biomechanical phenomena

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MDPI and ACS Style

Winkelmeyer, E.-M.; Schock, J.; Wollschläger, L.M.; Schad, P.; Huppertz, M.S.; Kotowski, N.; Prescher, A.; Kuhl, C.; Truhn, D.; Nebelung, S. Seeing Beyond Morphology-Standardized Stress MRI to Assess Human Knee Joint Instability. Diagnostics 2021, 11, 1035. https://doi.org/10.3390/diagnostics11061035

AMA Style

Winkelmeyer E-M, Schock J, Wollschläger LM, Schad P, Huppertz MS, Kotowski N, Prescher A, Kuhl C, Truhn D, Nebelung S. Seeing Beyond Morphology-Standardized Stress MRI to Assess Human Knee Joint Instability. Diagnostics. 2021; 11(6):1035. https://doi.org/10.3390/diagnostics11061035

Chicago/Turabian Style

Winkelmeyer, Eva-Maria, Justus Schock, Lena Marie Wollschläger, Philipp Schad, Marc Sebastian Huppertz, Niklas Kotowski, Andreas Prescher, Christiane Kuhl, Daniel Truhn, and Sven Nebelung. 2021. "Seeing Beyond Morphology-Standardized Stress MRI to Assess Human Knee Joint Instability" Diagnostics 11, no. 6: 1035. https://doi.org/10.3390/diagnostics11061035

APA Style

Winkelmeyer, E.-M., Schock, J., Wollschläger, L. M., Schad, P., Huppertz, M. S., Kotowski, N., Prescher, A., Kuhl, C., Truhn, D., & Nebelung, S. (2021). Seeing Beyond Morphology-Standardized Stress MRI to Assess Human Knee Joint Instability. Diagnostics, 11(6), 1035. https://doi.org/10.3390/diagnostics11061035

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